Abstract: Objective To investigate the triglyceride glucose (TyG) index and lipoprotein-associated phospholipase A2 (LP-PLA2) levels and their clinical significance in elderly patients with H-type hypertension and acute cerebral infarction (ACI). 
Methods A total of 97 elderly patients with H-type hypertension complicated with ACI (research group) and 148 elderly patients with H-type hypertension (control group) were retrospectively analyzed. The clinical data, and TyG and LP-PLA2 levels were compared between the two groups. According to the area of cerebral infarction, the elderly patients with H-type hypertension and ACI were divided into three subgroups: mild infarction group (n=31), moderate infarction group (n=42) and severe infarction group (n=24). The levels of TyG and LP-PLA2 in elderly patients with H-type hypertension and different degrees of ACI were compared. Pearson correlation analysis was used to analyze the relationship between TyG, LP-PLA2 levels and cerebral infarction volume. Multivariate Logistic regression analysis was used to determine the influencing factors of ACI in elderly patients with H-type hypertension. 
Results The proportion of grade 2/3 hypertension, systolic blood pressure, diastolic blood pressure, low-density lipoprotein cholesterol, homocysteine (Hcy), TyG, and LP-PLA2 levels in the research group were higher than those in the control group (P＜0.05). The levels of TyG (7.46±1.28, 8.15±1.32) and LP-PLA2 ［(197.85±38.62) μg/L, (229.74±47.51) μg/L］ in moderate infarction group and severe infarction group were higher than those in mild infarction group ［(6.83±1.15) μg/L and (175.68±34.59) μg/L］. The levels of TyG and LP-PLA2 in the severe infarction group were higher than those in the moderate infarction group (P＜0.05). TyG and LP-PLA2 levels were positively correlated with cerebral infarction volume in elderly patients with H-type hypertension and ACI (r=0.547 and 0.623, P=0.026 and 0.018). Multivariate analysis showed that hypertension (OR=2.912, 95%CI: 1.728-4.908), Hcy (OR=2.959, 95%CI: 1.756-4.987), TyG (OR=3.114, 95%CI: 1.848-5.248) and LP-PLA2 (OR=3.364, 95%CI: 1.996-5.668) were all related influencing factors for ACI in elderly patients with H-type hypertension (P＜0.05). 
Conclusion TyG and LP-PLA2 levels are increased in elderly patients with H-type hypertension and ACI. TyG and LP-PLA2 are closely related to ACI in elderly patients with H-type hypertension. 

Key words: hypertension, brain infarction, triglyceride glucose index, lipoprotein-associated phospholipase A2